arthroplasty
AOANJRR Registry Data and Prosthesis Selection
intermediate
6 min
20 marks
5 questions
Clinical Scenario
You are asked to discuss the evidence for prosthesis selection in joint arthroplasty with a registrar. A patient has also asked about the "best" hip replacement. You need to interpret registry data to guide clinical practice and counsel patients appropriately.
Graph showing cumulative percent revision rates from AOANJRR for different prosthesis combinations in total hip arthroplasty over 15 years of follow-up.
Image source: Open Access medical literature (NIH/PubMed Central) • CC-BY License
Questions
Question 1 (5 marks)
What prosthesis combination has the lowest revision rate for each major joint arthroplasty according to AOANJRR data?
Question 2 (4 marks)
How does patient age affect revision rates in THA and TKA?
Question 3 (4 marks)
What are the top three reasons for revision for hip and knee arthroplasty?
Question 4 (4 marks)
What are the strengths and limitations of using registry data for prosthesis selection?
Question 5 (3 marks)
How would you counsel a 55-year-old active male about prosthesis selection for THA?
Exam Day Cheat Sheet
Must Mention
- •AOANJRR = Australian registry, near-complete capture
- •THA: Hybrid or uncemented, metal/ceramic on HXLPE, 32-36mm head
- •TKA: Fully cemented, patella resurfaced, HXLPE
- •NOF: Cemented bipolar hemiarthroplasty
- •Age effect: younger = higher revision rate
- •Top reasons: loosening, infection, fracture/dislocation
Common Pitfalls
- •Recommending MoM (abandoned)
- •Not knowing age effect on outcomes
- •Treating registry data as RCT quality
- •Uncemented TKA (higher revision rate)
- •Not counselling about implant lifespan